check your understanding wk 7

Therapies for type I diabetes mellitus include (select all that apply) -insulin therapies -analgesia -daily exercise -NSAIDS -carbohydrate counting -hormonal medications

- insulin therapies -daily exercise -carbohydrate counting

A patient reporting vision changes, photophobia, and lid lag may be exhibiting signs of

Graves disease.

Gastroesophageal varices will be present with history of which of the following? (select all that apply) - smoking -hematemesis -gastric bypass surgery -alcoholism -chemotherapy -anemia

HAA - hematemesis -alcoholism -anemia

Which symptom suggests the presence of a hiatal hernia?

Heartburn

More than half of the initial cases of pancreatitis are associated with

alcoholism.

Aldosterone secretion is regulated by the presence of ________ in the circulation.

angiotensin II

acute lower quadrant pain associated with rebound tenderness and systemic signs of inflammation are indicative of

appendicitis

Hepatitis with the presence of autoantibodies and positive antinuclear antibodies (ANA) is

autoimmune hepatitis.

A patient who should be routinely evaluated for peptic ulcer disease is one who is

being treated with high-dose oral glucocorticoids.

Congenital adrenal hyperplasia (adrenogenital syndrome) results from

blocked cortisol production.

Hepatitis B is usually transmitted by exposure to

blood or semen

ulcerative colitis is commonly associated with

bloody diarrhea

An increase in ADH secretion occurs in response to

dehydration

chronic pancreatitis may lead to

diabetes mellitus

What laboratory data would support a diagnosis of hemochromatosis?

elevated ferritin

Fecal leukocyte screening would be indicated in a patient with suspected

enterocolitis.

Steatohepatitis is caused by an accumulation of ________ in the liver cells.

fat

A silent abdomen 3 hours after bowel surgery most likely indicates

functional bowel obstruction.

Dumping syndrome is commonly seen after __________ procedures.

gastric bypass

Untreated acute cholecystitis may lead to ________ of the gallbladder wall.

gangrene

What indicator is most helpful in evaluating long-term blood glucose management in patients with diabetes mellitus?

Glycosylated hemoglobin levels (HbA1c)

insulin binding to its receptor on target cells results in

increased facilitated cellular diffusion of glucose.

The finding of hypotension, rigid abdomen, and absent bowel sounds in a patient with pancreatitis

indicates peritonitis with substantial risk for sepsis and shock.

Propylthiouracil may be used to treat hyperthyroidism, because it

inhibits thyroid hormone synthesis.

For the individual with type 2 diabetes, the immediate problems brought about by hyperglycemia can lead to which of the following? (Select all that apply.) -Ketoacidosis Insulin resistance -Suppressed lipogenesis -Polydipsia and polyuria -Further diminished insulin secretion

-Further diminished insulin secretion -Insulin resistance -Polydipsia and polyuria

The strong risk factors for colon cancer include which of the following? (Select all that apply.)

AHCH Aging Hereditary Crohn disease High-fat diet

Appendicitis presents with which of the following clinical manifestations? (Select all that apply) -acute RLQ pain -intestinal perforation -rebound tenderness- leukocytosis -systemic signs of inflammation

ARS - acute RLQ pain -rebound tenderness -systemic signs of inflammation

Heartburn is most likely the consequence of which of the following? (Select all that apply.) -The backflow of gastric contents into the esophagus -Stimulation of the esophageal sensory nerve endings -A defect in the diaphragm -An esophageal spasm Portal hypertension

ATS -An esophageal spasm -The backflow of gastric contents into the esophagus -Stimulation of the esophageal sensory nerve endings

A biliary cause of acute pancreatitis is suggested by an elevation in which serum laboratory results?

Alkaline phosphatase

Chronic cholecystitis can lead to which complications (select all that apply) -biliary sepsis -gangrene -calcified gallbladder -peritonitis -porcelain gallbladder

BCP - biliary sepsis -calcified gallbladder -porcelain gallbladder

Chronic cholecystitis can lead to (Select all that apply.) -biliary sepsis -calcified gallbladder. -porcelain gallbladder. -cirrhosis. -diabetes mellitus.

BCP -biliary sepsis. -calcified gallbladder. -porcelain gallbladder.

What finding should prompt further diagnostic testing in a child presenting with diarrhea?

Blood and mucus in the stools

An early indicator of colon cancer is

Change in bowel habits

A patient with chronic gastritis would likely be tested for

Helicobacter pylori.

Type II DM is due to which of the following? (Select all that apply) - T-cell dysfunction - insulin resistance -b-cell dysfunction -pancreatic b-cell destruction -decrease in myoinositol transport

IB - insulin resistance -b-cell dysfunction

Hepatic encephalopathy is associated with

Increased blood ammonia levels

Which of the following are associated with pancreatitis? (select all that apply) -elevated serum magnesium levels -elevated serum lipase levels -elevated serum amylase levels -elevated serum calcium levels

LA - elevated serum lipase levels -elevated serum amylase levels

What effect would adrenocortical insufficiency have on an individual's response to surgical stress?

More prone to hypotension

Which response to an injection of ACTH indicates a primary adrenal insufficiency?

No change in serum glucocorticoid level

Microvascular complications of DM include (select all that apply) -retinopathy -enteropathy -myopathy -nephropathy -cardiopathy

RN - retinopathy -nephropathy

Ulcerative colitis and Crohn disease share several similarities. Specific distinctions or differences that are unique to Crohn disease include which of the following? (Select all that apply.) -Smoking's increasing the risk -Pain that is severe and localizedIncreased risk for colorectal cancer -Primary affecting of the proximal portion of the colon -Increased risk of developing intestinal cancer

SPP -Smoking's increasing the risk -Primary affecting of the proximal portion of the colon -Pain that is severe and localized

Individuals with diabetes mellitus are particularly susceptible to infections of which of the following? (Select all that apply.)Skin Vagina Esophagus Urinary tract Respiratory passages

SVU Skin Vagina Urinary tract

________ disease is a rare autosomal recessive disorder in which excessive amounts of copper accumulate in the liver.

Wilson

An urgent surgical consult is indicated for the patient with acute abdominal pain and

absent bowel sounds.

A viral hepatitis screen with positive hepatitis B surface antigen (HBsAg) should be interpreted as ________ hepatitis B.

acute

The most common cause of mechanical bowel obstruction is

adhensions

Liver transaminase elevations in which aspartate aminotransferase (AST) is markedly greater than alanine aminotransferase (ALT) is characteristic of

alcohol-induced injury.

What finding would rule out a diagnosis of irritable bowel syndrome in a patient with chronic diarrhea?

bloody stool

An infusion of mannitol would be prescribed to treat

cerebral edema

The definitive treatment for cholecystitis is

cholecystectomy.

Most gallstones are composed of

cholesterol.

Proton pump inhibitors may be used in the management of peptic ulcer disease to

decrease hydrochloric acid (HCl) secretion.

Diabetic neuropathy is thought to result from

decreased myoinositol transport

Epigastric pain that is relieved by food is suggestive of

gastric ulcer

A patient with a history of alcoholism presents with hematemesis and profound anemia. The expected diagnosis is

gastroesophageal varices.

The breakdown of stored glycogen in the liver and muscles is called

glycogenolysis.

A thyroid gland that grows larger than normal is known as

goiter.

The most common causes of prehepatic jaundice are ________ and ineffective erythropoiesis.

hemolysis

An increased urine bilirubin is associated with

hepatitis.

A patient with pancreatitis may experience muscle cramps secondary to

hypocalcemia.

A clinical finding that is consistent with a diagnosis of adrenocortical insufficiency is

hypoglycemia.

A laboratory finding that would help confirm the diagnosis of hyperaldosteronism is

hypokalemia.

A clinical finding consistent with a diagnosis of syndrome of inappropriate ADH secretion (SIADH) is

hyponatremia.

A patient presenting with muscle cramps, fatigue, anxiety, depression, and prolonged Q-T intervals on EKG may be showing symptoms of

hypoparathyroidism.

Surgical removal of a gland may result in

hyposecretion.

Myxedema coma is a severe condition associated with

hypothyroidism

The underlying pathogenic mechanism for type 2 diabetes is

insulin resistance and β-cell dysfunction.

The formation of active vitamin D

is impaired in renal failure

It is true that the synthesis of thyroid hormones

is inhibited by iodine deficiency.

Brain injury secondary to high serum bilirubin is called

kernicterus

The American Diabetes Association recommends a postprandial blood glucose level of ________ mg/dL for adults with diabetes.

less than 180

Jaundice is a common manifestation of

liver disease

It is true that gallstones are

more common in women.

Rupture of esophageal varices is a complication of cirrhosis with portal hypertension and carries a high ________ rate.

mortality

Premature infants are at greater risk for developing

necrotizing enterocolitis.

radioactive iodine treatment is the therapy of choice in patients with graves disease. the patient should be expected to

need lifelong thyroid replacement therapy

Type 2 diabetes mellitus is often associated with

nonketotic hyperosmolality.

Growth hormone-deficient infants would display

normal birth length and weight

________ is the most powerful predictor of developing type 2 diabetes mellitus.

obesity

A patient admitted with bleeding related to esophageal varices could be expected to receive a continuous intravenous infusion of

octreotide acetate.

Calcitonin is produced by thyroid parafollicular cells and increases bone formation by

osteoblasts.

The most challenging aspect of treatment for chronic pancreatitis is

pain control.

Elevated serum lipase and amylase levels are indicative of

pancreatitis.

a tumor which results in excessive production and releases of catecholamines is

pheochromocytoma

esophageal varices represent a complication of ____ hypertension

portal

Pathophysiologically, esophageal varices can be attributed to

portal hypotension

Barrett esophagus is a

preneoplastic lesion.

A type of insulin that would be most appropriate for acute management of hyperglycemia is

regular.

Patients with acute pancreatitis are generally made NPO and may require continuous gastric suctioning in order to

remove the usual stimuli for pancreatic secretion.

In type I diabetes, respiratory compensation may occur through a process of

respiratory alkalosis.

Clinical manifestations of hypoparathyroidism

result from decreased serum ionized calcium.

It is true that growth hormone excess in adults

results in the condition of acromegaly.

Diabetes mellitus is the ________ leading cause of death and a major cause of disability in the United States.

seventh

Narcotic administration should be administered carefully in patients with acute pancreatitis related to potential for

sphincter of Oddi dysfunction.

The pain associated with chronic pancreatitis is generally described as ____ in nature

steady and boring

It is true that biliary cancer

tend to be asymptomatic and progress insidiously

Clinical manifestations of Graves disease may include

tremor

A clinical finding consistent with a hypoglycemic reaction is

tremors

antidiuretic hormone (ADH) increases

water reabsorption in the collecting tubule of the kidney

Normal bile is composed of

water, electrolytes, and organic solutes.